At Boston Medical Center (BMC), caring for patients is a collaborative, multidisciplinary process. BMC’s Cancer Care Center organizes its services around each patient, bringing together the expertise of diverse specialists to manage care from the first consultation through treatment and follow-up visits. The Cancer Care Center is dedicated to providing treatment that is effective and innovative in curing and controlling cancer, while managing its impact on quality-of-life.

As the primary teaching affiliate of the Boston University School of Medicine, BMC combines personal, patient-focused care with the state-of-the-art-expertise and technological advances of a major teaching hospital. BMC is at the forefront of clinical practice, surgical expertise, and research in oncology.

Patients with kidney cancer, also called renal cell carcinoma (RCC), work with a urologist who takes the lead in the diagnosis, monitoring, and treatment planning of individual patients. Surgery is usually the first treatment for patients with malignant kidney tumors. 

The surgeons at BMC offer state-of-the-art surgical treatment and have extensive experience with using laparoscopic and robotic techniques to operate on kidneys. In fact, they performed some of the earliest such cases in the Boston area. When possible, the surgeons perform a partial nephrectomy, which involves removing only part of the kidney rather than a total radical nephrectomy, in which the entire kidney is removed. 

The BMC team follows the National Cancer Institute and the American Urological Association guidelines for the treatment of renal cell carcinoma. 

What is Kidney Cancer?

Kidney cancer begins in the kidneys. Each of the two kidneys are about the size of an adult fist, bean-shaped and weigh around 150 grams each. One kidney is located at each side of the backbone, just under the rib cage. They are protected from injury by a large padding of fat, the lower ribs, and several muscles.

The kidneys play a major role in maintaining general health and wellbeing. Their purpose is to continuously sort non-recyclable waste from recyclable waste in the body while also cleaning the blood. The kidneys make urine from excess fluid and unwanted chemicals or waste in the blood.

Kidney cancer is caused by the abnormal growth of cells in the kidneys. Renal cell carcinomas (RCCs) make up approximately 90% of kidney cancer cases. Other types of kidney cancers include:

  • Transitional cell carcinoma, or kidney pelvis cancer which begins in the lining of the kidney pelvis
  • Wilms tumor (nephroblastoma), the most common cancer in children 14 and under
  • Renal sarcoma, which is rare, develops in the soft tissue of the kidney

According to the American Cancer Society, kidney is the ninth most common cancer in the United States, accounting for approximately 3.7% of new cancer cases in 2016. Among men, the kidneys and renal pelvis (combined) is one of the top 10 cancer sites, and the seventh most common cancer.

Causes of Kidney Cancer

There are several risk factors of kidney cancer, including gender, age, race, and lifestyle choices. Men are nearly twice as likely to develop RCC as women. Kidney cancer is typically found in people age 50-75, with the average age of diagnosis being 64. The risk of developing the disease is slightly higher for African Americans and American Indians/Alaska Natives than for Caucasians.

Other risk factors include:

  • Smoking
  • Obesity
  • Exposure to certain substances in the workplace
  • High blood pressure
  • Certain genetic and hereditary conditions (such as von Hippel-Lindau disease, hereditary papillary renal cell carcinoma, and others)
  • Family history of the disease
  • Advanced kidney disease

Symptoms of Kidney Cancer

Early kidney cancers do not usually cause any signs or symptoms, but larger ones may. Some possible signs and symptoms of kidney cancer include:

  • Stomach pain
  • Lower back pain on one side
  • Blood in the urine
  • Loss of appetite

These symptoms, however, can be caused by other benign diseases.

Kidney Cancer Staging

Staging is the process of determining how extensive the cancer is. It is an important part of diagnosis because the stage determines the most appropriate course of treatment options. The stages of kidney cancer range from Stage I (the least severe stage) to Stage IV. When patients are confirmed to have kidney cancer, the doctor will discuss the staging.

Stage I The tumor is 7 cm or smaller and is only located in the kidney. It has not spread to the lymph nodes or distant organs.

Stage II The tumor is larger than 7 cm and is only located in the kidney. It has not spread to the lymph nodes or distant organs.

Stage III Either of these conditions:

  • A tumor of any size is located only in the kidney. It has spread to the regional lymph nodes but not to other parts of the body.
  • The tumor has grown into major veins or perinephric tissue and may or may not have spread to regional lymph nodes. It has not spread to other parts of the body.

Stage IV Either of these conditions:

  • The tumor has spread to areas beyond Gerota's fascia—the layer of connective tissue compressing the kidneys and the adrenal glands—and extends into the adrenal gland—small glands located on top of each kidney that produce hormones—on the same side of the body as the tumor, possibly to lymph nodes, but not to other parts of the body.
  • The tumor has spread to any other organ, such as the lungs, bones, or the brain.

Contáctenos

Tratamientos y Servicios

Tratamientos para el cáncer de riñón por etapa

Estadio IA: por lo general, requiere cirugía con una nefrectomía parcial (generalmente mediante nefrectomía parcial robótica o laparoscópica). La vigilancia activa con imágenes seriadas se realiza en pacientes seleccionados y la ablación por radiofrecuencia se realiza para los candidatos no quirúrgicos que requieren tratamiento.

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Ablación por radiofrecuencia para el cáncer

La ablación por radiofrecuencia (ARF) es un tratamiento del cáncer en el que la energía de radiofrecuencia, derivada de la energía eléctrica y magnética, se envía por medio de una sonda estrecha que se coloca en el centro de un tumor pulmonar. No se requieren incisiones quirúrgicas y las sondas se colocan en los tumores mediante una tomografía computarizada para guiar al médico. La RFA es un método más nuevo para tratar el cáncer de pulmón, así como los cánceres de hígado, riñón y hueso. La RFA puede atacar y destruir las células cancerosas sin afectar los tejidos sanos que están cerca del cáncer. Los tratamientos sistémicos, como la quimioterapia y ciertos tipos de radiación, se absorben tanto en el tejido sano como en el enfermo, mientras que la RFA se administra directamente al tumor.

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Crioterapia

La crioterapia es el uso de congelar tejido o células enfermas dentro del cuerpo para eliminar esas células para que el cuerpo pueda desarrollar células nuevas y saludables.

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Inmunoterapia

Para los pacientes con melanoma en estadio avanzado, la inmunoterapia puede mejorar la respuesta inmune natural del cuerpo al cáncer. La inmunoterapia recluta el propio sistema inmunológico del cuerpo y lo usa para combatir el cáncer en todo el cuerpo, lo que dificulta que las células cancerosas se escondan o desarrollen defensas contra él. La inmunoterapia tiene el potencial de seguir funcionando incluso después de que el paciente haya completado el tratamiento.

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Quimioterapia

La quimioterapia es un medicamento o una combinación de medicamentos que se usan para tratar el cáncer. La quimioterapia puede administrarse por vía oral (en forma de pastilla) o inyectarse por vía intravenosa (IV).

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Radioterapia

La radiación utiliza un equipo especial para liberar partículas de alta energía, como rayos X, rayos gamma, haces de electrones o protones, para matar o dañar las células cancerosas. La radiación (también llamada radioterapia, irradiación o terapia de rayos X) se puede administrar internamente a través de la implantación de semillas o externamente usando aceleradores lineales (llamada radioterapia de haz externo o EBRT).

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Resección robótica

Para este procedimiento, su cirujano guía los instrumentos robóticos para realizar la cirugía mientras está sentado en la consola de la computadora a unos metros de distancia. Los movimientos naturales de sus manos se transmiten a los instrumentos robóticos, lo que permite un control preciso durante su operación.

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Diagnósticos y Pruebas

Because kidney cancer is usually asymptomatic, the tumor is usually found when a patient undergoes a medical test for another reason.  Still, a doctor may order the following tests to confirm the diagnosis.

Tomografía computarizada (TC)

Las tomografías computarizadas utilizan equipos de rayos X y procesamiento por computadora para producir imágenes bidimensionales del cuerpo. El paciente se acuesta en una mesa y pasa a través de una máquina que parece una rosquilla grande y cuadrada.

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Resonancia magnética

Una resonancia magnética es una imagen de diagnóstico no invasiva que no utiliza radiación ionizante. Es una forma indolora e inofensiva de mirar el interior del cuerpo sin utilizar rayos X. En su lugar, utiliza un imán grande y una computadora para escanear el cuerpo. Esto le proporciona al médico información que no está disponible en otras exploraciones.

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Nuestro Equipo

Urologic Surgeons

Mark H Katz, MD

Assistant Professor of Urology, Boston University School of Medicine

David S Wang, MD

Associate Professor of Urology, Boston University School of Medicine

Radiation Oncologists

Medical Oncologists

Recursos del Paciente

Additional Information

Resumen de la Investigación

Kidney Cancer Clinical Trials

Boston Medical Center has a wide variety of clinical trials mainly funded by the National Cancer Institute (NCI). NCI is coming up with new and innovative clinical trials for kidney cancers that are, or will be, available at Boston Medical Center. 

CIRB #H-35254/SWOG #S1500 (PAPMET): A Randomized, Phase II Efficacy Assessment of Multiple MET Kinase Inhibitors (Cabozantinib, Crizotinib, Savolitinib, and Sunitinib) in Metastatic Papillary Renal Carcinoma

HIRB #2016-19/Janssen RIVA STM4001: Efficacy and Safety of Rivaroxaban Prophylaxis Compared with Placebo in Ambulatory Cancer Patients Initiating Systemic Cancer Therapy and at High Risk for Venous Thromboembolism

Afiliaciones

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As the principal teaching affiliate of Boston University School of Medicine (BUSM), Boston Medical Center is devoted to training future generations of healthcare professionals.  Learn more about Boston University School of Medicine.